evidence-based blog of Filippo Dibari

Posts Tagged ‘malnutrition’

A new UN body to combat global malnutrition?

In Over-nutrition, Under-nutrition on October 15, 2014 at 10:22 am

By Elena L. Pasquini 14 October 2014

from Devex web site

 

The United Nations is considering setting up a new body to address global malnutrition as early as next month, Devex has learned.

Tentatively called “U.N. Nutrition,” the new entity will be headed by UNICEF and the World Food Program, according to well-placed sources within civil society groups attending this week’s Committee on World Food Security, or CFS, in Rome. Over the weekend, the sources also participated in working groups ahead of the second International Conference on Nutrition — known as ICN2 — jointly led by FAO and the World Health Organization in November.

During the informal talks, the rumor circulated among attendees, Stefano Prato, managing director of the Society for International Development, told Devex in Rome.

“We had confirmation from U.N. insiders [and] also from delegates that there is a concrete plan,” he said.

Civil society groups believe the model for U.N. Nutrition could be Scaling Up Nutrition, a country-led global platform that seeks to unite governments, civil society, U.N. agencies, donors, businesses and researchers in a collective effort to improve nutrition through specific interventions — including support for breastfeeding and nutrition-sensitive approaches in areas such as agriculture or WASH.

“We are [also] quite sure that it will be based on PPPs, integrating governments and the private sector,” Prato added.

U.N. Nutrition could be launched a month from now in ICN2, and civil society organizations hope more details will emerge publicly this week so the plans are “disclosed with transparency” and CSOs are allowed to give feedback on whether “it’s the right answer to malnutrition, or if there are other [solutions].”

UN Nutrition vs. CFS

On Monday, the first session of the CFS was abuzz with gossip over the rumored new agency and how it will complement the current intergovernmental body and multistakeholder platform based in Rome.

For CSOs, the first question was which organization should take the lead in the fight against global malnutrition.

“Nutrition is not a problem of delivering, it is an issue of policies,” Prato said. “We believe the nutrition question has to be addressed through [shared] rules and regulations. That’s why we suggest a strong role for CFS.”

According to the SID official, the involvement of UNICEF and WFP says something about the direction the initiative is taking: “WFP and UNICEF are not organizations where there is a sovereign assembly, such as the FAO or WHO … programs [are] driven by donors and with also a quite restricted range of donors … It is not a context of democratic dialogue and those are not spaces for [defining] policy.”

Civil society, he insisted, wants malnutrition programs to be driven by policies rather than by donors or private sector interests.

“We don’t want this role bypassed by programs defined by donors without mechanisms of consultation and control,” Prato said. “What we fear is the establishment of mechanisms that are not legitimate and not accountable.”

In this scenario, a leading role for the private sector raise further concerns for CSOs, which believe strengthening local food systems based on the diversity of agricultural systems is the key to addressing malnutrition, instead of solutions based on delivery of products, fortification, dietary supplements or processed food.

“Clearly, big multinational corporations … are very much interested [in] that … approach,” Prato said. “What we fear is the participation of the private sector without clear rules of engagement and therefore [leading to] a conflict of interest.”

ICN2, a weak step forward?

The plans for a new U.N. body focused on nutrition is part a process that it is expected to reach its high watermark at the ICN2 in November, when FAO and WHO member states are expected to endorse Sunday’s consensus on a political declaration and framework for action to fight global malnutrition.

But according to Prato, the political declaration is “extremely weak,” as it doesn’t include tangible commitments or provide any timeframe for implementation. Moreover, the framework for action is nonbinding and there is “nothing new” in its concept.

“There is a dilution of the [centrality] of the right to food … the importance of local food systems is mentioned, but very poorly,” he said. “Above all, there are … no obligations … no control and accountability mechanisms … In short, it is fundamentally a big set of words.”

Prato would rather U.N. Nutrition stay within the framework of CFS. The SID official insisted CFS must comply with its mandate to properly address the problem of global malnutrition and argued its role should be strengthened ahead of ICN2.

Is a new U.N. body the solution to combat malnutrition? And how will it complement the current multistakeholder platform based in Rome? Please let us know your thoughts by sending an email to news@devex.com or leaving a comment below.

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IYCF-E Toolkit: Rapid start-up resources for emergency nutrition personnel

In Under-nutrition on September 22, 2014 at 6:00 pm

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From Save the Children web site.

Disruption and displacement of populations in emergency situations greatly impacts the health and nutrition status of infants and young children. During emergencies, even in previously healthy populations, the rates of child mortality can soar up to 70 times higher than average and child morbidity and crude mortality rates can increase by 20% in 2 weeks due in particular to diarrhea and consequent malnutrition; the youngest babies being the most vulnerable. The Lancet demonstrated that optimal breastfeeding and complementary feeding could reduce child mortality in children under five more than any other preventative measure by up to 26%. In emergencies, this potential to save children’s lives through optimal breastfeeding and complementary feeding could be even higher. In emergencies, the total infant mortality rate for infants under 1 year is 12-53% higher than normal. In emergencies, feeding practices can be undermined by displacement, insecurity, lack of privacy and poor access to adequate nutrition for both mother and child. Adequate nutrition and care of children has been identified as one of the key factors to promote child health and stability and IYCF-E support has consequently become a major strategy in reducing child morbidity and mortality during humanitarian emergency response.

As stated above, malnutrition is one of the major threats to child survival during an emergency and for those who survive it, it can also have tremendous consequences on their cognitive, social, motor skill, physical and emotional development. If caught in time malnutrition can usually be treated but this is not always the case. Further management of acute malnutrition in infants is complicated by a lack of evidence and knowledge about diagnosis and the most appropriate treatment protocols in different contexts. For a myriad of reasons prevention of malnutrition must be the goal, with treatment as a safety net. The best way to prevent malnutrition is through ensuring optimal feeding and care for children through supporting exclusive breastfeeding, appropriate complementary foods, and a supportive care environment – the backbone of IYCF-E programming. 

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Exploring the paradox: double burden of malnutrition in rural South Africa

In Over-nutrition, Under-nutrition on April 18, 2014 at 7:11 am

by Kimani-Murage EW.

Glob Health Action. 2013 Jan 24;6:19249

(download)

Abstract

BACKGROUND:

This article is a review of the PhD thesis by Elizabeth Kimani-Murage that explores the double burden of malnutrition in rural South Africa. This is in the context of a worryingly rapid increase in obesity and obesity-related diseases in low- and middle-income countries (LMICs) including South Africa, and in the wake of on-going nutrition transition and lifestyle changes in these countries.

OBJECTIVE:

To understand the profiles of malnutrition among children and adolescents in a poor, high HIV prevalent, transitional society in a middle-income country.

METHODS:

A cross-sectional growth survey was conducted in 2007 targeting 4,000 children and adolescents aged 1-20 years. In addition, HIV testing was carried out on children aged 1-5 years and Tanner pubertal assessment among adolescents aged 9-20 years.

RESULTS:

The study shows stunting at an early age and adolescent obesity, particularly among girls, that co-exists in the same socio-geographic population. The study also shows that HIV is an independent modifiable risk factor for poor nutritional outcomes in children and makes a significant contribution to nutritional outcomes at the individual level. Significant predictors of undernutrition at an early age, documented at individual, household, and community levels, include child’s HIV status, age and birth weight, maternal age, age of household head, and area of residence. Significant predictors of overweight/obesity and risk for metabolic disease during adolescence, documented at individual and household levels include child’s age, sex, and pubertal development, household-level food security, socio-economic status, and household head’s highest education level.

CONCLUSIONS:

The combination of early stunting and adolescent obesity raises critical concerns in the wake of the rising public health importance of metabolic diseases in LMICs. This is because, both paediatric obesity and adult short stature are risk factors for metabolic syndrome and metabolic diseases in adulthood. Clearly, policies and interventions to address malnutrition in this and other transitional societies need to be double-pronged and gender-sensitive.

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Food safety risks and consumer health

In Under-nutrition on February 2, 2014 at 11:27 am

by Bruce M. Chassy

New Biotechnology – Volume 27, Issue 5, 30 November 2010, Pages 534–544

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The major food safety risks are not eating a healthy diet, and failure to avoid foodborne illness. Over one billion people in the world suffer from food insecurity and malnutrition. Nutritionally enhanced transgenic crops such as Golden Rice are one potential strategy for reducing malnutrition in the world.
Transgenic crops are subjected to a rigorous pre-market safety assessment. The safety of novel proteins and other products is established, and through compositional analysis and animal studies, the safety of any observed changes is evaluated. These studies provide evidence that the new product is as safe as, or safer than, comparable varieties.
It must be asked, however, if this rigorous analysis is necessary, because unregulated crops produced by other breeding methods also undergo genetic changes and contain unintended effects. Golden Rice poses infinitesimally small, if any, risk to consumers whilst it has the potential to spare millions of lives each year.
However, because it is a transgenic crop, it cannot be deployed without years of expensive pre-market safety review. Paradoxically, if Golden Rice had been produced by less precise conventional methods of breeding, it would already be in the hands of poor farmers.
It is concluded that the hyper-precautionary regulatory process applied to transgenic crops works to the extreme disadvantage of the hungry and the poor.
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PROFILES: A Data Based Approach to Nutrition Advocacy and National Development

In Under-nutrition on December 15, 2013 at 9:20 am

 

From Fanta III website

“PROFILES is an evidence-based advocacy tool to support increased political and social commitment to nutrition. PROFILES uses computer models and up-to-date country-specific data to project, over a defined period of time, the consequences that malnutrition will have on national development. It estimates the cost savings that reducing malnutrition will have over that time period in terms of lives improved and saved, and the economic losses averted. Those estimates are then used to engage country governments and other high-level stakeholders in a collaborative process to identity and prioritize actions to reduce malnutrition. Such actions may include developing or refining policies, more effectively implementing existing policies, identifying priority geographic areas in which selected interventions should be focused, and scaling up interventions.”

More info and documents are available on fhi360 website:

Pdf Profiles – A Data Based Approach to Nutrition Advocacy (Front Matter) (782 kb)

Pdf Profiles – A Data Based Approach to Nutrition Advocacy (Pages 1 – 10) (1 mb)

Pdf Profiles – A Data Based Approach to Nutrition Advocacy (Pages 11 – 20) (6 mb)

Pdf Profiles – A Data Based Approach to Nutrition Advocacy (Pages 21-30) (2 mb)

Pdf Profiles – A Data Based Approach to Nutrition Advocacy (Pages 41-50) (3 mb)

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